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WAL-MART PHARMACY 10-5997
CH093590 UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.
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Covered Entity Details
Entity Name
UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.
Subdivision Name
CONTINENTAL FAMILY MEDICAL CTR
Type
HRSA-Funded Health Center
340B ID
CH093590
Entity Address
1260 S. CAMPBELL RD
BLDG 1
GREEN VALLEY, AZ 85614
Grant Number
H80CS00416
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5997
Pharmacy Address
9600 PARKSOUTH CT. SUITE 100
ORLANDO, FL 32837
Pharmacy Comments
Contract Details
Approval Date
7/12/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Claudette Pippin, Chief Executive Officer - Interim
(520) 407-5602
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/12/2022
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